The American Medical Association is urging CMS to maintain its Jan. 1, 2027, electronic prior authorization deadline.
CMS broadened prior authorization reform efforts — and built upon payers’ existing commitments — to include providers and EHR vendors. Application programming interface requirements are slated to go live in 2027 under the Interoperability and Prior Authorization final rule.
In a Sept. 18 letter, AMA CEO John Whyte, MD, said that health plans are “mischaracterizing” limited physician engagement as lack of interest.
“Some stakeholders are seeking a delay in supporting [electronic prior authorization],” the letter said. “Broad nonenforcement during 2027 would risk slowing development, testing, and deployment, leaving physicians reliant on faxes, phone calls, payer portals, and repeated data entry while patients continue waiting for medically necessary care.”
Dr. Whyte said physicians need more education and support from health plans and EHR developers. Some knowledge gaps include what capabilities will be available Jan. 1, what to expect with workflow updates and how to report issues. The notion that physicians are not interested, rather than not supported, “is a manufactured problem created to justify a delay,” he wrote.
“Without clear and timely information, practices cannot build change management plans, train staff, participate in testing or serve as active partners in improving [electronic prior authorization] so it delivers on its promise,” the letter said.
Some payers have already gone live with relevant APIs, including UnitedHealthcare, Network Health and Aetna through their work with Epic.
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